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Analysis: Can Mindful Eating Really Help You Lose Weight Or Stop Binging?

(t-mizo/Flickr)

(t-mizo/Flickr)

Updated 1/23

By Jean Fain
Guest Contributor

Mindfulness is all the rage. But does mindful eating — paying very close attention to your food and to your body’s signs of true hunger and satiety — really help you lose weight or stop binging?

On the one hand, paying closer attention to how you eat and why seems like a no-brainer for improved health. But in fact, mindful eating is steeped in controversy — pitting doctors against nutritionists, parents against children, therapists against clients, even colleagues against one another.

Proponents of mindful eating (also known as intuitive eating) like nutrition researcher Linda Bacon and other advocates of “Health at Every Size” — a self-described political movement promoting healthy habits and self-acceptance, rather than diets — recite a lengthy list of benefits related to mindful eating.

Critics of mindful eating offer a number of negatives: some say such navel-gazing about food makes it unappetizing, while others say mindful eating is superficial and ineffective, even irresponsible when it supplants traditional treatments for life-threatening eating issues.

Still others, like many who posted comments on my recent NPR interview with Jean Kristeller, author of the book, “The Joy of Half a Cookie,” dismiss mindful eating as a joke. One example: “Yes, let’s add more dietary neurosis to the babel of nutritional advice. How about this: eat the whole cookie. Have two, even. Just eat cookies less often, and eat nutritious food as the rule rather than the exception.”

According to Dr. James Greenblatt, an eating disorder expert, chief medical officer of Walden Behavioral Care and the author of “Answers to Binge Eating,” mindful eating is not only pointless in some cases, it’s potentially dangerous.

“Mindful eating clearly has a place in our treatment plans,” Greenblatt explained in a recent email exchange. “But, as a sole intervention for some of our patients, it is like asking opiate abusers to utilize mindful heroin detox. Many eating disorders reflect a severe neurochemical abnormality that needs to be addressed with biological interventions first, before adding other psychotherapeutic strategies and mindfulness.”
Continue reading

‘Dietland’: A Fat Heroine, And The Politics Of Weight

By Jean Fain

The heroine is the news in “Dietland,” the new novel by Sarai Walker. That’s because she’s got the rarest of qualities in a female protagonist: She’s fat.

Also, she has next to no sense of self, and expects to remain selfless until she can afford weight-loss surgery and find her true self as a thin person. In the meantime, Plum Kettle, our heroine, works as a ghostwriter for the slender, glamorous and self-absorbed editor of a teen magazine called Daisy Chain. In short, Plum’s got no life of her own.

Plum’s transformation from fat girl to full-bodied rebel with a cause is the narrative arc of Walker’s provocative and insightful book. Like “Alice in Wonderland,” Plum’s sense of self gets turned on its head by a cast of oddball characters, from the daughter of a famous diet guru and her feminist cohort to a murderous terrorist cell of women avenging crimes against women. When the daughter of the diet guru offers Plum $20,000 to postpone her surgery and confront the real costs of beauty, the plot and subplot blend and thicken.

dietlandDespite the rave reviews from my inner circle and the world at large, I didn’t expect to be drawn in by the writing. But, truth be told, it’s fresh, playful and sometimes hilarious: The parody of the diet industry is spot on. I also didn’t expect to be touched by the rejection and humiliation the 300+ pound Plum encounters along the way to finding herself.

Most unexpected of all: I kind of looked forward to spending my evenings with a fictional someone desperately seeking weight loss. Generally, if I’m desperate for anything at the end of the day with clients (I’m a therapist specializing in eating disorders and food issues), it’s non-diet-related downtime.

I can’t say I always loved reading “Dietland.” Violence, even when served as Walker serves it — with sarcasm and panache — isn’t my cup of tea. I also had trouble swallowing the meanness of the male characters, and the complete self-acceptance of the female ones. And yet, my curiosity kept me turning all 307 pages. I wanted to know if Plum would live more happily ever after. Plus, I wanted to discuss the book with members of my mindful eating support group. (“Dietland” is the group’s first unofficial book club selection.)

At the same time, I kept reading between the lines to learn the author’s story. From the book-jacket flap, I knew Walker writes from professional experience. Before she did her doctoral research on the feminist issue that is fat, she wrote about body image for “Our Bodies, Ourselves,” the feminist classic by the Boston Women’s Health Collective.

From the author photo, I also knew Walker is a fat woman. And yet, combing through the reviews and interviews, I could find very little about Walker’s personal experience with food and body image issues.

The therapist in me really wanted to know if Walker, like Plum, had tried and failed to lose weight over and again? If she’d been a victim of fat shaming and stigma? If she’d been discriminated against because of her appearance? What was Walker’s story?

My curiosity moved me to set up a Skype interview with the NYC-based author. What follows are questions and answers from that recent interview with Sarai (pronounced SUH-ray) Walker.

JF: You seem to know a lot about food and body image issues even though you’re not a medical person or scientist. What can you tell me about your personal experience in this arena?

SW: Well, I’m a fat woman, and so I think one of the reasons I wanted to write “Dietland” is I wanted to explore what it’s like to be a fat woman in our contemporary society because I think, while there are some novels with fat heroines, I feel like there aren’t any novels that explore the issue in a serious way. Continue reading

A Weight Watching Life, And (Maybe) A Post-Diet Era

The diets in my life have come and gone: the grapefruit diet, no-fat diet, juice cleanses and Atkins. But through it all, there’s always been Weight Watchers. With its point system and lo-cal dinners, weigh-ins and group therapy vibe, Weight Watchers offered an all-encompassing road map to controlled eating. I tried it, Betty Draper of “Mad Men” tried it, you probably know someone who’s been there. It was a diet, yes, but also more: a structure to control the chaos of disordered eating.

Sadly, as many of us know, no single “diet” really works. Without a wholesale lifestyle shift, and replacing old, destructive patterns with healthier habits — a much slower and sometimes painstaking process — one failed diet begets another and another.

Reading the obituary of Jean Nidetch, a founder of Weight Watchers who died this week at 91, made me realize, yet again, the obsessive and punishing ways we compel ourselves to diet, and how, deep down, food and weight are as much about emotion as physiology. The New York Times described Nidetch as “pumpkin-shaped all her young life” and “raised in a family that ate as a consolation for disappointment.” Here’s more:

She was born Jean Evelyn Slutsky in Brooklyn on Oct. 12, 1923, the daughter of David and Mae Rodin Slutsky. Her father was a cabdriver and her mother a manicurist. Her compulsive eating habits began as a child, she recalled in a memoir…

“I don’t really remember, but I’m positive that whenever I cried, my mother gave me something to eat,” she wrote. “I’m sure that whenever I had a fight with the little girl next door, or it was raining and I couldn’t go out, or I wasn’t invited to a birthday party, my mother gave me a piece of candy to make me feel better.”

And that launched a life of binge eating and yo-yo dieting. Eventually, though, it pushed Nidetch to seek an escape: through tough-love control and, well, vigilant weight watching.

But we’re not in Brooklyn with the Slutskys anymore. Diets have evolved. Lifestyle Medicine is all the rage, and a far more holistic, Pollan-esque approach to food is taking hold. (“Eat food. Not too much. Mostly plants.”) Also, it turns out, not all calories are alike.

Are we then, at long last, in a post-diet era? Can we all just agree that diets do not work in the long term? I asked Jean Fain, a Harvard Medical School-affiliated psychotherapist and the author of “The Self-Compassion Diet” for her thoughts on the passing of a diet icon and where Weight Watchers stands today. Here’s what she wrote:

As the embodiment of Weight Watchers, Jean Nidetch did a lot of good. Her success (she lost 72 pounds and kept it off) inspired waist watchers to stop looking to medical professionals to solve their eating issues and to start finding inspiration, strength and direction from those who understand the problem far better – other successful dieters.

With a little support from fellow Weight Watchers, members not only learn that yes, they can lose weight, they find out they can have a lot more fun as group, rather than try to go it alone.

Inadvertently, Nidetch also did real harm with her eating system and the conditional support that goes with it. (Members get applause and other positive reinforcements for losing weight, for instance, but little or nothing for gaining weight.)

While Weight Watchers insiders claim their program is more successful than other diets, studies that compare various diets to each other do not support that. Whether or not the international slimming organization actually has a 16% success rate, (a number quoted in the book “Secrets from the Eating Lab” by Traci Mann) truth be told, the overwhelming majority regain what they lose and sometimes more. Diets like the one the organization promotes can exacerbate the very eating problems they were hoping to resolve. When that happens, those who most need support are least likely to get it because they’re too ashamed to go to meetings, let alone get weighed in.

More than a Weight Watchers ice cream bar, a lo-cal recipe or the conditional support of a group that fails to acknowledge the shame that members carry, what waist watchers need more than anything is a heaping helping of self-compassion.

Compassion for yourself is the missing ingredient, the antidote to this and most other weight-loss programs because most plans revolve around self-discipline, deprivation and neglect. You’re supposed to stick to the plan no matter what. If you’re starving, keep eating tiny portions. If you’re exhausted, keep moving – no pain, no gain. Going on vacation? Keep counting points, calories or carbs. It’s not a very compassionate (or realistic) approach; it’s not very effective. And it’s no fun. Continue reading

Weight Loss Clinics Provoke Questions About Extreme Diet Plan

By Karen Weintraub
Guest Blogger

 

When I first heard that Medi-Weightloss Clinics puts clients on a 600- to 800-calorie-a-day diet, I was horrified. How could that be safe? Even if someone could stick to a crash diet like that, wouldn’t they just regain all the weight the minute they started eating again?

Now that I’ve done some digging, though, I’m having a harder time being judgmental. Sure, the diet is drastic. Sure, most people will regain most of the weight they lose. Sure the program is expensive – at least as costly as a weight loss program at Tufts Medical Center, arguably one of the best nutrition research institutions in the country. But…

The problem is that no diet plan is really all that great. Most people can lose a decent percentage of their extra pounds; most people can’t keep them off for more than a year.

That’s not to say that people should give up or that weight loss is hopeless, just that it’s very very hard. And everyone has to find a way that works for them.

Maybe losing 20 pounds in a month and 50 in four is enough motivation for some people to keep on going and to transform their eating habits and lifestyles. Maybe paying $1,200 for 14 weeks of treatment at Medi-Weightloss instead of as little as about $100 for Weight Watchers over the same period encourages some people to be more careful about what they eat, to work out a little harder. Continue reading